The global push for sexual and reproductive health and rights (SRHR) has been around for at least seven decades. Africa still lags behind the rest of the world, however. There is a need to intensify the pace of awareness and uptake of the benefits of SRHR education.
There is also a need to improve the legal and regulatory environment for SRHR, 70 years since bold public discourse on planned parenthood came into the open.
Small groups of bold women came together, in the 1950s, determined to sensitise communities and families around the world on sexual and reproductive health. They took humankind into spaces that had, hitherto, been considered taboo in many societies. Seven decades later, the conversation has spread to the four corners of the globe. It is addressing a wide slate of issues on SRHR, both through local and global initiatives. Yet a lot more remains to be done.
In Africa, for instance, great strides have been made towards the provision of reproductive health education and services. Even consciousness of what needs to be done may represent movement. But we must move from awareness to practice, by addressing a number of critical things. These include reform of abortion laws, more sex and reproductive health education, advocacy, and provision and use of contraceptives.
In some countries, such as Benin, the legal environment has gone ahead of time to address harmful colonial laws that have survived the years. In Kenya, there is a need to decriminalise access to safe abortion, by reforming the laws and policies on access and procurement of abortion. Elsewhere, the US government and Congress need to pass the Global Health, Empowerment and Rights Act, which would end US interference in what NGOs do with their own money.
Abortion is Health Care Everywhere Act
The United States also needs to pass the ‘Abortion is Health Care Everywhere Act.’ This would repeal the Helms Amendment of 1973, to allow the United States to support the full range of sexual and reproductive health services that people around the world want and need. The amendment will have major health and economic benefits for numerous countries.
Sexual reproductive health development partners and donors, for their part, need to put their money where their mouth is. The current funding space has been outpaced by advocacy. It needs to close up the gap. Indeed, poor funding slows down even education and advocacy services in stigmatic environments. Slowing down advocacy is not the kind of closing of the gap required. Rather, it is the bridging of the gap through funding that moves the benefits of education and advocacy closer to the desired goals.
Such are some of the concerns that have emerged from the Sixth International Conference on Family Planning (ICFP), in Pattaya, Thailand (14 – 17 November 2022). ICFP is a movement towards universal access to family planning services, contraception, and other SRHR resources.
For nearly 12 years, the ICFP community has worked to move family planning and reproductive health priorities to the centre of development. Since the first ICFP in Kampala, Uganda in 2009, ICFP has served as a strategic inflection point for the global reproductive health community. It has been a global stage for countries, organisations, and individuals to make important commitments and celebrate achievements at the world’s largest scientific conference on family planning and reproductive health.
Spirit of partnership
But ICFP has also become more than a conference. It has evolved into a platform for researchers, advocates, governments, and communities, and a movement towards achieving access to family planning for all. It is growing into a professional community, guided by the spirit of partnership, inclusivity, innovation, and scientific rigour.
The three-day meeting in Thailand had over 5,000 in-person participants, and thousands more online. It had an unprecedented number of discussions on abortion. There was momentum, as well, in the discussions on the prevalence of contraceptives and the rate of uptake of family planning in various countries across the world. African countries, like Kenya, were lauded for high uptake of contraceptives, especially among the youth. The uptake has been proven to enhance the quality of life by delaying childbearing.
The Ipas Global CEO, Dr Anu Kumar, challenged the USAID on the Helms Amendment and the strain it has caused on funding for reproductive health around the world. The Helms Amendment, signed into law in 1973, is an amendment to the US Foreign Assistance Act of 1961. It prohibits the use of foreign assistance to pay for abortion as a method of family planning or to motivate or coerce any person to practice abortion. The Helms Amendment has placed low- and middle-income countries—where the United States has a strong presence through other health and development programs—as abortion rates tend to be relatively high and many abortions are unsafe.
Guttmacher Institute studies have shown that the failure of the United States, and other countries, to fully support access to safe abortion services contributes to the more than 35 million unsafe abortions that occur annually in low- and middle-income countries, leading to 23,000 preventable maternal deaths.
Dr Akol is Regional Director, Ipas Africa Alliance